低出生体重儿暂时性低甲状腺素血症相关因素的临床研究

目的 探讨低出生体重儿、足月儿甲状腺素（TSH,FT3,FT4）水平及其与体重、胎龄的关系,为制定临床早期干预方案提供理论依据.方法 选择低出生体重儿180例,胎龄为27～41周,作为本次研究对象.胎龄27～41周,其中＜34周（A组）40例,～37周（B组）73例,＞37周（C纽）67例.对照组（D组）为本院同时出生的足月儿,适于胎龄儿60例.同时将所有低出生体重儿分为暂时性低甲状腺素血症（THOP）组（120例）和非THOP组（60例）.电化学发光法测甲状腺激素水平.结果 外周血清TSH浓度随胎龄、出生体重增加降低,FT3,FT4浓度随胎龄、出生体重的增加而成升高趋势,即各组TSH比较情况为：A组＞B组＞C组＞D组,FT3,F4比较情况为：A组＜B组＜C组＜D组；TSH与胎龄、出生体重成负相关,FT3,FT4与胎龄、出生体重成正相关；低出生体重儿外周血清TSH浓度低于足月儿外周血清TSH浓度.结论 ①低出生体重儿血清FT3,FT4浓度与胎龄、出生体重成正相关.胎龄越小,出生体重越低,越容易出现THOP.②低出生体重儿血清TSH浓度低于足月儿血清TSH浓度,与胎龄、出生体重成负相关；低出生体重儿外周血清TSH浓度低于足月儿外周血清TSH浓度.

Clinical Study on Thop Relevant Factors of Low Birth Weight Infants

Objective To discuss the relationship between thyroxine（TSH,FT3 ,FT4） levels and weight,gestational age,height, clinical evaluation of growth in low birth weight infants and full-term infants. To provide clinical theoretical basis for establishing early intervention treatment which will improve long-term quality of life of LBWI. Methods 180 LB／VI whose gestational age were 27 -41 weeks were chosen from Maternal and Chihl Health of WeiFang from July 2005 to March 2008 as sttnty group,98 boys and 82 girls included,among them 40 cases＇gestational age were 27 -34 weeks（ group A） ,73 eases＇were 34 -37 weeks（group B） ,67 eases＇were 37 -41 weeks（group C） ,60 cases of full-term inthnts and appropriate for＂ gestational age were born at the same time of our hospital were selected as control group. All LB- WI were divided into two groups,THOP and nou-THOP. All the infants＂ parents are healthy, mothers have no histoL＇y of thyrnid disease, and had not taken any thyroxine or anti-thyroid drugs during pregnancy. Results The thyroxine levels increased with the increase of GA and FIW, that is A 〈 B 〈 C 〈 D, Compared each two groups, the difference between them had statistical significance. The thyroxine levels（TSH, FT3, FT4） had a positive relationship with GA and BW. By multivariate conditional Logistie regression analysis,it was found that the incidence of THOP was related with maternal and neonatal TORCH infection ,gestalional hypertension, LBWI, respiratory distress syndrome, polyeyth emia, neonatal septicemia,asphyxia,septic shock. Conclusion Thyroxine levels of LBWI were positively correlated with GA and BW. It indicated that tire earlier the infant was delivered,the higher the risk of THOP was. The concentration of TSH of LBWI was lower than full term infants